Hearing is an important tool for connecting a person to the outside world. When hearing impairment is impaired, the load on the brain in the temporal lobe narrows, attention is overloaded and the cognitive abilities of the person (thinking, memory, ability to learn) are falling.
In addition, reduced hearing creates problems when communicating with other people and limits the adaptive capabilities of the person. If you hear your ears poorly, you should soon consult a otolaryngologist (ENT doctor) for advice.
Hearing loss is otherwise called hearing loss. The condition is distinguished by degrees, depending on how far a person hears spoken language.
Degree of hearing loss
|Threshold sound perception||Distance of speaking|
|Easy - 1 degree||26-40 decibel||4-6 meters|
|Medium - 2 degree||41-55 decibel||1-4 meters|
|Heavy - 3 degree||56-70 decibel||0.25-1 meter|
|Deep hearing loss - Grade 4||71-90 decibel|
|Deafness||> 91 decibel|
Why hearing is reduced
About 8% of the world's population has hearing problems, in fact, this figure is too low. Since not everyone addresses this problem to specialists. Men suffer from hearing loss more often than women. The most frequently acquired hearing problems begin after 50 years.
- peripheral part (outer, middle ear), conducting sound
- sensory epithelium of the inner ear, perceiving the signal
- auditory nerve transmitting impulse
- and the central part, analyzing the incoming information (cortical analyzer or a portion of the cerebral cortex in the temporal lobe).
Hearing loss can be associated with injuries or diseases of any part of the auditory pathway. In addition, problems with blood supply to the ear or brain become a common cause of reduced hearing capacity.
Conductive hearing loss
When the reason lies in the violation of the conduct of sound on the outer and middle ear, talking about conductive hearing loss.
- External auditory canal can be closed by sulfur plugs.
Sulfur is a natural secret of the outer ear, which, with poor hygienic care, frequent inflammatory diseases of the ears, or mechanical stimulation of the ear, can accumulate in the form of dense traffic jams that prevent the passage of a sound wave. The problem is often bilateral and is directly related to the habit of brushing your ears with cotton buds, matches, or other unsuitable objects. Ears should not be cleaned, but washed. This rule is advisable to know both adults and children. Read more about sulfur plugs .
- Foreign body hearing aid
This is a more childish problem. Kids often put small balls, berries or parts from LEGO in their ears. The process is often one-sided, although there are craftsmen at once to clog both ears. Adults are more likely to suffer from insects that have got into the ear or match heads that have broken off when cleaning the ears. It is easier to warn than to try to remove the trifle that has fallen into your ear.
Middle catarrhal or purulent otitis media (inflammation of the middle ear) due to effusion can significantly reduce hearing from one or both sides (see the symptoms of otitis in children ). If an abscess is opened on the eardrum, and a hole is formed, then there may be no hearing on one or both ears until it heals or promptly restores. If the healing of the eardrum occurs with the formation of a large or rough scar, this will be the cause of persistent hearing loss on the affected ear.
- Mechanical injury of the eardrum
This is the result of mindless tinkering in the ears. The barotrauma of this department is a consequence of the impact of a sound wave or high pressure. Most often, it is received by those who are struck on the ear, hunters who have been shot over their ears, as well as divers - losers.
- The furuncles of the auditory canal with a considerable size and due to edema can also reduce hearing.
Sensorineural or neurosensory hearing loss is a consequence of problems with the host: the inner ear, 8 pair of cranial (pre-door-cochlear) nerves or cortical and stem centers of the auditory analyzer.
Congenital variants of neurosensory hearing loss - they most often appear when the sensory epithelium of the inner ear is underdeveloped. Infectious processes carried by the mother during pregnancy are most often responsible for this.
Congenital hearing loss in a child
- With intrauterine rubella infection, the child may be born with the Greg triad (deafness, heart disease and eye damage).
- Fetal syphilis also leads to deafness.
- Vertical infection with chlamydia during childbirth can cause hearing loss in the newborn.
- Deep prematurity (up to 32 weeks) does not allow neurosensory apparatus to grow and leads to hearing loss.
- Mothers of alcoholics and drug addicts because of the ototoxic effect of the substances they take, children are often born with reduced hearing.
- Congenital inherited malformations - aplasia of the cochlea and the labyrinth: Mondini, Shaybe, Michael - the causes of congenital deafness. Syndromes of Gervella (hearing loss and heart disease), Pendred (hyperplasia of the thyroid gland and deafness), Ushera (retinitis and hearing loss), Wardenburg (eyes of different colors, accrete eyebrows, gray strand over his forehead and hearing loss), Stickler (strong myopia, hyeroma, hiatus, gray eyes, hearing loss) early cataract, hearing impairment) - also hereditary congenital diseases.
- Children with Down syndrome are often deaf from birth.
Sensorineural hearing loss
Neurosensory hearing loss can be acquired in childhood or adulthood. In the first place of its causes - violations of hearing hygiene.
- Prolonged exposure to loud sounds (louder than 90 decibels) leads to disruption of the perception of high frequency sounds.
- The elderly suffer from presbyacusis, that is, the degeneration of the hearing aid.
- The abuse of headphones affects the auditory nerves and is known as “telephone operator disease”. Pathology is associated with a violation of the myelin sheath of the auditory nerve. This is actually the chronic neuritis of the auditory nerve , in which inflammation makes it difficult to conduct impulses normally.
- Low frequencies of perception of sounds fall out in Meniere's disease , accompanied by frequent systemic vertigo and loss of balance, hearing loss and tinnitus.
- Traumatic injuries of the temporal bone, snail. 8 pairs of cranial nerves, cerebral cortex in the auditory centers can be the causes of secondary sensorineural hearing loss on one or both sides.
- Viral infectious diseases (measles, mumps , herpes, rubella, flu) can damage the auditory nerves.
- Bacterial lesions in the labyrinth, temporal bone, Eustachian tube, or the meninges lead to hearing loss or deafness.
- Autoimmune diseases (eg, Wegener's granulomatosis) are the primary cause of otosclerosis and hearing loss.
- Chronic allergic rhinitis causes catarrhal chronic otitis media, which often leads to hearing loss in childhood.
- Otosclerosis or the growth of bone and connective tissue in the inner ear can lead to permanent hearing loss.
- Tumors of the pre-vesicular nerve (neuromas), neoplasms of the bridge-cerebellar angle or meninges can lead to hearing impairment.
A variety of drugs have an ototoxic effect.
- Aminoglycosides (kanamycin, gentamicin, streptomycin, amikacin), especially in combination with furosemide, give hearing impairments.
- By themselves, diuretics, as well as macrolide antibiotics (josamycin, azithromycin), nonsteroidal anti-inflammatory, can cause reversible hearing impairment that occurs after drug withdrawal.
Hearing loss on the background of circulatory disorders
Often, neuropathologists, in addition to complaints of pain in the head or neck, tinnitus and ringing in the temples , sleep and memory disorders, hear from patients: “I hear badly with one ear.” A patient with similar complaints, in addition to the routine ENT examination, showed a more in-depth study of the neck vessels (UZDG) and pictures of the spine in two projections.
Such a decrease in hearing can hide the vertebral artery syndrome, the blood flow through which worsens osteochondrosis changes of the cervical spine or stenosis of the carotid arteries, which even threatens with ischemic stroke. For vascular hearing impairment, patients should receive courses of vasodilator drugs and antiplatelet agents twice a year. With the failure of conservative therapy may be a question about surgery on the vessels.
In acute disorders of cerebral circulation, in case of involvement of 8 pairs of cranial nerves (pre-door-cochlear) into the focus, persistent hearing loss may be observed. in this case, the patient is conducted according to the standard program of treatment and rehabilitation after a stroke.
Ear hears bad what to do
All obstacles in the path of the sound wave should be removed.
- Sulfur plugs and foreign bodies
They are removed in an outpatient setting at the otolaryngologist. A few days before the procedure, the doctor may recommend to bury hydrogen peroxide. Next, the doctor blows his ears over Polittser or washes out traffic jams. Foreign bodies from the ear canal are also removed by a doctor.
- Otitis media
Otitis at the stage of catarrhal inflammation can be treated with otipax or albumin in drops. From the moment of the purulent process, local (Polydex) or system (macrolides, cephalosporins, fluoroquinolones) antibiotics are connected. Drops in the ear are prohibited when perforating the eardrum. Otitis treatment can be supplemented with anti-inflammatory and analgesic drugs. It is obligatory in parallel with otitis to treat a runny nose (Vibrocil, Rinoflumicili). Camphor alcohol is used only in compresses at the stage of catarrhal otitis. It does not drip into his ear because of the risks of otosclerosis.
- The boil in the ear is treated with antibiotics, antiseptics and surgical treatment.
- Persistent or too large perforations of the eardrum can be quickly restored using tympanoplasty.
Correction of neurosensory hearing loss
Only the acute form of sensorineural hearing loss can be cured completely, for example, against the background of the neuritis of the auditory nerve. By this is meant a hearing loss that developed acutely within 72 hours and affected one or both ears. Often patients complain: “I hear badly after a cold”.
Although up to two thirds of patients may further get improvement without therapy, otolaryngologists consider waiting tactics to be wrong. In this case, from the very first days of treatment, glucococtical anti-inflammatory drugs are used in pills or injections.
- With residual hearing loss, the drugs are injected into the ear or transtimpanally. Previously widely used vascular drugs, dextrans and decongestants today are inferior to glucocorticoids and are prescribed only for acute hearing loss on the background of circulatory disorders (strokes).
- In Meniere's disease, Betaserc and Idebenone are effective, as well as diuretics, which reduce the number of endolymph in the cochlea.
- In chronic forms of hearing loss most often have to resort to hearing aids. In the first place today, especially in children's practice, cochlear implants come out - hearing aids, which can be installed inside the ear for constant wear. They are small, do not cause discomfort and directly stimulate the auditory nerve.
- Hearing aids of various modifications, from ear to ear, require individual selection and a certain time for getting used to. Many patients, especially the elderly, refuse hearing aids due to poor selection of the device and the inconvenience of wearing it.
Alternative ways to restore hearing
- способен улучшать кровоснабжение внутреннего уха и коры головного мозга. Massage of auricles is able to improve the blood supply to the inner ear and cerebral cortex. Its type is acupuncture massage or qigong techniques, borrowed from Chinese medicine. Auxiliary tool. Which in itself does not solve the problem.
- – физиолечение, не решающее проблему кардинально. Microcurrent reflexology is a physiotherapy, which does not fundamentally solve the problem.
- способны расширить диапазон воспринимаемых звуков. Audio games can expand the range of perceived sounds. More suitable for training healthy ears.
- с произношением согласных звуков, проталкиваемых из ротоглотки в ухо, а также тренировки с звуковоспроизводящими устройствами – невредное развлечение на этапе самостоятельных занятий. The technique of M. Norbekov with the pronunciation of consonant sounds pushed from the oropharynx into the ear, as well as training with sound reproducing devices is harmless entertainment at the stage of independent study. From the moment of attraction to paid courses - sectarianism harmful to health and pocket.
Thus, hearing loss is a serious problem that can and should be dealt with. In case of acute hearing impairment, the most correct tactic is to immediately consult a doctor. After all, lost time can result in persistent hearing loss.